Edward Fisher, Medicare Insurance Broker

Answer: You probably have a Medicare Supplement, which may raise rates annually. Keep in mind that every year you are a year older and according to the statistics, you are likely to be at a higher risk for medical expense claims than you were the year before.

It's not just you; it's all the people in your age group whose risk profile has changed. Insurance works by spreading to risk among a large group. Some, like you, may not be likely to have a claim in a given year, but there are others in the group that will incur large expenses that have to be covered. Next year it could be you.

Answer: No, Medicare does not cover medical marijuana even if it's prescribed for chronic pain or cancer.

There may be coverage for some FDA-Approved cannabinoid prescription medications if they are on the plan's formulary. Check with the agent or the insurance company to be sure.

Answer: If you're getting bills, you're signed up for Part B. Apparently at enrollment, you did not specify how you wanted to pay the Part B premium. There are some options.

The easiest way is to have Social Security deduct the premium from your monthly check.

Alternatively, you can set up a monthly draw from your bank account, you can go online to your Medicare account and make a payment, or you can have Medicare draw the payment from your account using "Medicare Easy Pay."

Answer: Maybe. Before you make any change of plans, make sure your doctors accept the new plan you're considering. An agent can review all the plans available to you in your county and determine which ones include your doctors.

Put the agent to work!

Answer: I suggest keeping them for a couple of years. This lets you go back and review your medical history easily, so that you can make any changes you need during the Annual Enrollment Period.

Answer: The biggest reason is that Advantage plans are based on networks of providers.

This means that if you have an Advantage HMO plan and you go to a provider out of their network, you will not have coverage.

If you have an Advantage PPO plan and you go out of network, you will pay a higher co-pay, out of pocket.

If your healthcare providers are in the network, Advantage plans may be the way to go. About 50% of Medicare beneficiaries have Advantage plans.

Answer: No, but it's almost always a good idea if you don't already have acceptable (by Medicare standards) coverage.

The most frequent situation is someone still working and covered by an employer's group plan.

Answer: The easiest way is to have a Medicare agent do the legwork for you. We have software that will sort through all the plans in your county and find the ones that cover your prescriptions.

If you want, you can go online and call up the formulary for each insurance plan you are considering. A formulary is just a list of what's covered and how each drug is priced.

Recommendation: Put an agent to work for you.

Answer: Original Medicare will cover standard monovision lenses at 80%. If premium or advanced lenses are used, the difference will be out of pocket, in addition to the 20% not covered by Medicare.

Supplements generally provide coverage for this procedure without an out-of-pocket cost.

Answer: A signed Scope of Appointment form is mandatory according to Medicare rules. The SOA will list all of the allowable subjects to be discussed in your meeting or conversation with your agent. The permitted subjects are Advantage Plans, Supplements, Prescription Drug Plans, Hospital Indemnity Plans and Dental/Vision/Hearing Plans. Call centers are not exempt from this regulation.

Answer: Who says regular Medicare is better than an advantage plan? Remember that regular Medicare generally only pays 80% of most medical expenses leaving the patient with the bill for the 20% it doesn't cover.

As always, each individual case must be evaluated on its own merits. Original Medicare or Regular Medicare does not cover prescription drugs, dental, hearing or vision. Most advantage plans cover those things. It's always best to look at all your options. An agent can help you sort this all out and help you arrive at the best solution for you.

Answer: No, you will not lose your Medicare benefits. Medicare is not like a group health plan through an employer that can cover a family on one policy. If you get married, each spouse will have their own Medicare account, assuming you both qualify.

Answer: You don't need to file Form SSA-44 because an event like a 401(k) withdrawal or a home sale do not qualify you for a premium reduction. The premium will automatically drop down in 2027 because it's based on the income shown on your 2025 tax return, as long as it's below the IRMAA thresholds.

The bottom line is that you don't have to do anything for the 2027 premium reduction.

Answer: That's an easy one. It's the agent's job to make sure the Advantage plan being considered is accepted by her current doctors. Every carrier provides access to its roster of "in network" providers.

Remember: If the plan is an HMO, you must go to an in-network doctor or they won't pay. If the plan is a PPO, you can go outside the network, but you will pay a higher co-pay.

As always, your individual situation determines the best way to go.

Answer: It all comes down to your preference. Are you more comfortable with face-to-face contact with the agent rather than remotely? Either way works fine.

Remember: All Medicare agents must be licensed to do business in your state, whether in person or remotely. All agents are also required to be re-certified each year by each carrier they represent.

With today's technology, agents and clients can see each other online and review documents together, even though they are not in the same place. More and more seniors are getting accustomed to doing things virtually because of e-commerce and to stay connected with their children and grandchildren. The key is whether you trust the agent you're working with to put your best interest first.

Answer: Yes, hospice care is covered by Medicare Part A. Medicare doesn't pay for room & board in a facility, such as a hospital or hospice facility so it makes sense to an Advantage plan, a Supplement and/or a hospital indemnity plan.

Answer: Medicare is complicated and ever-changing. Each person's situation is different, so the "one size fits all" approach doesn't work. Agents can help you navigate your way to the best plan for you.

We can answer your questions. Some people don't even know what questions to ask. There's no shame in that and no reason to be embarrassed; that's what your agent is here for.